Epilepsy, Mood and Sleep

Epilepsy is much more than seizures – it can affect many aspects of an individual’s overall health, from mood and behavior, to memory and sleep. Learning about the relationship between epilepsy and other conditions is an important step in managing this very complex condition.

Mood and behavior

Many people with epilepsy may experience changes in their emotional state, often as a side effect of seizure medications. Emotions and moods are clearly connected to a specific portion of the brain, the limbic area. This area is frequently involved in seizures and seizure-like activity. Seizure medicines work by changing the actions of cells in that part of the brain, but then they also can affect other things that those cells are responsible for, such as moods and emotions. Additionally, one medicine might make a person feel differently from another medication because different seizure medicines work on different chemicals or neurotransmitters in the brain. Side effects can occur and can worsen someone’s emotional state if the amount of medicine they take is increased too quickly or the level in their blood is too high.

The most common mood disorders in people with epilepsy are major bouts of depression and dysthymia. Anxiety, while not technically a mood disorder, is another common emotion that occurs more often in people with epilepsy. The most effective treatment for mood disorders is an antidepressant. There also are many types of counseling that can be used effectively either alone or in conjunction with medication.

Thinking and memory

Often epilepsy will affect a person’s ability to think clearly or remember things. Seizures can affect the brain in a few ways and can disrupt the area of the brain in charge of a particular function. So, if seizures happen in the area in charge of language, a person may not be able to name an object when they see it. Seizures can also stop the communication between different areas of the brain. The lines are cut, so to speak. Even though a person may know the name of an object, the part of the brain that knows that name isn’t able to communicate it to the rest of the brain. The area of the brain where seizures start may determine tell what functions may be affected. If seizures start in several areas, or are generalized, they may affect many different functions at once.

If a seizure starts in the temporal lobe, it can largely affect the hippocampus, which is linked to memory. If seizures starting here go untreated, the hippocampus begins to harden and shrink, storing information in a disorganized way. Fortunately, there is one hippocampus on each side of the brain, so if one side is affected by a seizure, the other can help.

Sleep

Sleep deprivation is a strong risk factor of frequent seizures. In specific syndromes, such as juvenile myoclonic epilepsy, this relationship can be dramatic to the point where seizures rarely or never happen when sufficient sleep is obtained. Sleep deprivation also increases the risk of partial seizures in many patients, particularly when occurring frequently.

Seizures themselves could also be the cause of sleep deprivation. Studies have shown that overall, about 20 percent of seizures occur during sleep. The Epilepsy Foundation notes that most sleep seizures begin during stage two of the sleep cycle, with few beginning during “slow wave” sleep. These are times during which the electrical activity of the brain is more synchronized, which is why scientists believe that seizures are more likely to begin during these states. That said, it’s very important for people with epilepsy to maintain good sleep hygiene and to consistently get a good night’s rest.